Paediatrician says ‘no evidence’ more children die in hospital at weekends

Allan Scott

A leading children’s doctor has concluded that, having analysed over half a million admissions, there is no evidence children are more likely to die after being admitted to hospital at the weekend compared to weekdays.

The paper, which is being presented at the St Andrew’s Day Symposium - hosted by the Scottish Paediatric Society, in partnership with the Royal College of Paediatrics and Child Health, the Royal College of Physicians of Edinburgh, the Royal College of Physicians and Surgeons of Glasgow and the Scottish Association of Community Child Health - has shown that between January 1, 2000, and December 31, 2013, there were 251 deaths between Monday and Friday and 84 on the weekend.

It also suggests that paediatric care in Scotland may actually be better at weekends with 7.8 per cent of patients admitted between Monday and Friday needing readmission but only 7.3 per cent of those admitted at weekends having to return to hospital.

The analysis was undertaken in light of the UK Government’s Keogh Report which cited evidence from adult patients that mortality was higher after a weekend admission.

The study, which uses data from 574,403 admissions of patients up to the age of 16 who were admitted to Scottish hospitals also found:

·The busiest day of the week was Monday (16 per cent of admissions) and the quietest was Saturday (12 per cent of all admissions);

·Children admitted on Friday (44 per cent) were most likely and Sunday admissions were least likely to be discharged on the same day as admitted (40 per cent);

·In NHS Grampian, public holidays which fell on weekdays experienced weekend-like activity and admissions reached a peak at 11am which persisted to 11pm;

·There was a 20 per cent increase in admissions with conditions requiring intensive or high dependency care at weekends compared to weekdays;

This reflects a smaller total number of children being admitted at the weekend but the same number of children with very serious conditions being admitted seven days a week.

Lead author and member of the Royal College of Paediatrics and Child Health, Dr Steve Turner, said: “There are increasing pressures on hospital services but relatively little is known about the numbers of paediatric admissions.

‘‘This study aimed to help plug this gap in knowledge and help us identify how any increase in demand on paediatric services might be managed in future.

“Although the numbers are mercifully small, our research shows there were no more deaths over weekends than during week days.

‘‘Our results also suggest that extrapolating evidence from adult care to the paediatric setting is not always accurate.”

Dr Turner added: “There is always room for improvement in healthcare for children.

‘‘To make these improvements we need to get a better idea of quality of care in hospitals and better understand what happens to children within the healthcare system before and after a hospital admission.”

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